Summary: The Council has delayed meeting Ms C’s adult social care needs, and Mr B’s needs as a carer. The Council’s communication has been poor. Mr B supports Ms C, but this has a negative impact on their relationship, causing stress and anxiety. Mr B has had time and trouble chasing the Council for information and clarity and feels unsupported. The Council will apologise, make acknowledgement payments to Mr B and Ms C, complete Ms C’s care and support review or reassessment without further delay, and remind staff of the importance of clear communication and chasing referrals.

The complaint

1. The complainant, who I will call Mr B, says the Council delayed completing a care needs assessment for his daughter, Ms C. Following the care needs assessment, the Council has failed to put in any support to meet Ms C’s care and support needs. Mr B says there are errors in the assessment, such as saying Ms C can self-advocate which is at odds with a psychology report she has. Mr B feels this shows the Council has not properly understood Ms C or her autism, as Ms C is very good at mimicking and appg more able than she is. Ms C will also say ‘the right things’ but it does not mean she can achieve them.
2. Mr B says the Council contacted Ms C’s college without telling her, it disclosed her personal information without her consent and arranged a meeting at college when Ms C wishes to keep her education and care support separate.
3. Mr B has essentially been meeting Ms C’s needs himself with no support, he says the Council has not offered a carers assessment. Ms C is missing out on support to help her live more independently and socialise with other people. This puts a strain on the relationship Ms C has with her father and causes her anxiety. Mr B feels ignored by the Council and does not feel it genuinely wants to help support people to be part of society and achieve their full potential.

Back to top

The Ombudsman’s role and powers

4. We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word fault to refer to these. We must also consider whether any fault has had an adverse impact on the person making the complaint. I refer to this as ‘injustice’. If there has been fault which has caused an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
5. If we are satisfied with a council’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(i), as amended)

Back to top

How I considered this complaint

6. I considered:
• Information provided by Mr B in e-mails and a telephone conversation.
• Information provided by the Council in response to my enquiries.
• The Care Act 2014 and associated statutory guidance.
• The Mental Capacity Act 2005 and associated statutory guidance.
• Responses to a draft statement.
7. Mr B and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

Back to top

What I found

Ms C’s care and support needs

8. Ms C is a young adult with autism, she lives with her father, Mr B who provides all support with her daily living needs.
9. Sections 9 and 10 of the Care Act 2014 require local authorities to carry out an assessment for any adult with an appearance of need for care and support. They must provide an assessment to all people regardless of their finances or whether the local authority thinks an individual has eligible needs. The assessment must be of the adult’s needs and how they impact on their wellbeing and the results they want to achieve. It must also involve the individual and where suitable their carer or any other person they might want involved.
10. The Council started the assessment process for Ms C in August 2019, before the assessment was complete, the staff member went on long term sick leave. This was out of the Council’s control. Mr B at first said he was happy to wait for the return of the member of staff but as time went on and he was ringing for updates he asked that somebody else complete the assessment. In December 2019 Mr B agreed that things were stable, and the assessment should proceed in the new year. Mr B heard nothing further from the Council so chased it in March. The Council was then unable to meet with Ms C because of the Covid-19 pandemic restrictions, and Ms C was showing possible symptoms. All parties agreed to wait until it was safe to have a face-to-face assessment. The Council started the assessment in July 2020 and completed it within two months.
11. Under the Mental Capacity Act, you cannot assume someone cannot make a decision for themselves just because they have a particular medical condition or disability. The Council recorded on Ms C’s care needs assessment that it did not doubt she had capacity to take part in the assessment, and that she could communicate and understand her care and support needs. Mr B comments that Ms C is adept at mimic and compliance, and he doubts the Council properly understood her understanding of her capabilities.
12. The Council decided Ms C has eligible care needs in the following areas:

• Needs support with preparing meals, to learn skills to complete this independently.
• Needs support with cleaning and managing finances. Wants to learn skills to manage independently.
• Needs support to go out independently in the community. Only for the first few times and can then do independently.
• Needs support to access and engage in work.
• Needs support to explore social groups and activities.

13. The Care Act 2014 gives local authorities a legal responsibility to provide a care and support plan (or a support plan for a carer). The care and support plan should consider what the person wants to achieve, what they can do by themselves or with existing support, and what care and support may be available in the local area. When preparing a care and support plan the local authority must involve any carer the adult has. The support plan may include a personal budget which is the money the council has worked out it will cost to arrange the necessary care and support for that person.
14. The Council provided Ms C with an indicative personal budget of £50 per week if it were to commission services to meet her needs. The Council decided it could meet Ms C’s needs by referrals to community groups, which are a free service. Ms C’s care and support plan shows a personal budget of zero, because the cost of her support package is free. The Council made referrals to two organisations it thought could support Ms C.
15. Section 27 of the Care Act 2014 gives an expectation that local authorities should conduct a review of a care and support plan at least every 12 months. The authority should consider a light touch review six to eight weeks after agreement and signing off the plan and personal budget. The Council confirms it aims to complete reviews within six weeks of the implementation of support. It should carry out the review as quickly as is reasonably practicable in a timely manner proportionate to the needs to be met. As well as the duty to keep plans under review generally, the Act puts a duty on the local authority to conduct a review if the adult or a person acting on the adult’s behalf asks for one. Local authorities should establish systems that allow the proportionate monitoring of both care and support plans and support plans to ensure that needs are continuing to be met. A review will show what is working, what is not working and what might need to change. Is the current method still the best one for what the person wants to achieve, or should other methods be considered?
16. The Council e-mailed Mr B around eight weeks after the referrals to check if the organisations it had referred to had been in contact. Since then, Mr B has contacted the Council many times to explain Ms C is not engaging with the contacts from the community groups and she feels anxious about it. Mr B has explained how stressful it has been during lockdown, he provides all support to Ms C, and has told the Council that they need help. Mr B frequently asked the Council to explain what the community groups would provide so that he could explain it to Ms C, but he did not receive this information until he spoke with one of the groups and understood how it could benefit Ms C. Mr B also asked the social worker to meet with Ms C to explain it to her, but this request was not answered. The Council did offer to help Ms C with a telephone call with the community groups and did offer to have a video meeting with Mr B, Ms C and one of the community groups but never arranged this. The Council’s notes say this was because it thought Mr B may digress from what it wanted to discuss.
17. The Council says the reason Ms C is not receiving support is because she is not engaging, rather than through any fault of the Council. The Council says it would not expect to do anything in this situation and would not consider any alternative ways to meet Ms C’s needs. The Council says Ms C does not need a formal package of care, her needs can be met by community groups and its only duty is to signpost her.
18. The concept of meeting needs recognises that everyone’s needs are different and personal to them. Local authorities must consider how to meet each person’s specific needs rather than simply considering what service they will fit into. The concept of meeting needs also recognises that modern care and support can be provided in any number of ways, with new models emerging all the time, rather than the previous legislation which focuses primarily on traditional models of residential and domiciliary care.
19. The Council has a duty to meet needs rather than to provide services. There are many ways to meet an individuals specific needs. The guidance says “The local authority must take into consideration the individual’s preferences. The authority should consider the person’s goals in approaching the authority for support, and the level or nature of support desired. Where the person wishes to take more control over their own care and support, this should be reflected in the route taken. Similarly, where the person asks for more local authority support (for example, because they lack the skills or confidence to engage with the provider market and do not have family or friends who are willing and/or able to support them with this), the authority should respond accordingly in the decision taken about how needs will be met”
20. The Council is still trying to connect Ms C to community groups. The Council says it struggled to contact Ms C so got in touch with her college. I have seen no evidence in the case notes of the Council’s attempts to contact Ms C. The case notes show the Council discussed with the college the kind of support it was looking to put in place for Ms C, and the college said it had an independent living suite the support workers could use to support Ms C with things like cooking skills. The Council arranged a meeting at the college but did not tell Ms C this. Ms C was distressed to find this out from the college. Mr B says the Council disclosing information to college about Ms C’s care support is a breach of her personal data, and that Ms C did not want her college to know about her care support and wanted to keep it separate from her education.

Mr B’s support needs

21. Where an individual provides or intends to provide care for another adult and it appears the carer may have any needs for support, local authorities must carry out a carer’s assessment. Carers’ assessments must seek to find out not only the carer’s needs for support, but also the sustainability of the caring role itself. This includes the practical and emotional support the carer provides to the adult.
22. Where the local authority is carrying out a carer’s assessment, it must include in its assessment a consideration of the carer’s potential future needs for support. Factored into this must be a consideration of whether the carer is, and will continue to be, able and willing to care for the adult needing care. (Care and Support Statutory Guidance 2014)
23. The Council made a referral for a carer’s assessment for Mr B in July 2019. A contractor acting for the Council recently contacted Mr B to arrange this. Mr B declined as was expecting contact from the Council. The Council had not told Mr B it contracts out the service. The Council has now completed Mr B’s carers assessment.

Was there fault causing injustice?

24. I must now consider whether there was fault in the Council’s actions, which have caused Mr B and Ms C an injustice.
25. The Council correctly completed a care needs assessment, and care and support plan for Ms C, by meeting with her and discussing the outcomes she wishes to achieve. However, there was delay in the process between January and March when Mr B had to chase the Council. The Council says this was because of the Covid-19 pandemic, but I have seen no evidence of this.
26. Although the Council did not complete an assessment between August 2019 and July 2020 this was because of factors outside of its control (staff absence and Covid-19) which it made Mr B aware of and he agreed to wait. It is possible that had the Council got in touch with Mr B promptly in the new year, the Council could have completed Ms C’s assessment before the Covid-19 restrictions came in. However, its likely the required support would still have been delayed.
27. Though Mr B raises concerns about Ms C’s capacity I find no reason to question or criticise the Council’s decision. The Council has acted in accordance with the Mental Capacity Act 2005 and the Care Act 2014. Ms C engaged in the assessment, and the Council captured her needs based on the outcomes she wishes to achieve. Mr B comments that Ms C is very good at mimicking behaviour so appearing more capable than she is, she also tends to simply agree to things or say what she thinks others want to hear. I find if the care support had started it would have been reviewed, and if it wasn’t working changes would be made. Therefore, if there were any issues in assessment because of Ms C’s behaviour, this would have been picked up down the line. Because the care support has not started this opportunity has not arisen.
28. The Council found Ms C has eligible care and support needs which it has a duty to meet. The Council can meet these needs by referral to other organisations offering free services, which it did in this case, that is not fault. However, the care and support plan, and correspondence with Ms C and Mr B, does not explain how these organisations would meet Ms C’s needs. It appears to me that one was for support to access and engage in work, and to explore social groups and activities. The other was to support with independence in preparing meals, cleaning, managing finances and going out independently. This was never made explicit, despite Mr B’s queries, and I find the poor communication is fault.
29. Mr B repeatedly asked the Council for clarity, and it did not respond to these requests. The Council did offer to support Ms C to engage but took no other action to review what the barriers to her engaging are and whether the care and support plan remained the most appropriate way to meet needs given Ms C’s anxiety about engaging with the provider. I find it unfair of the Council to say the only reason Ms C’s needs are not met is because she is not engaging. The Councils’ records shows it knew in September 2019 that Ms C finds multiple calls and e-mails overwhelming, that she wouldn’t always respond, and that she needs to be able to digest and consider her response. Ms C’s ‘all about me’ booklet shows she prefers e-mail communication, yet she received calls and texts. Mr B has told the Council Ms C is anxious and that he needs more clarity on what the groups will provide to try and explain it to Ms C and show her the benefits. The Council should have answered these queries and should have considered a review of whether the current care plan was still the best method to meet Ms C’s needs.
30. It has been confusing for Mr B and Ms C to understand what should happen. It is not clear what information the Council has given the groups about Ms C’s needs and the outcomes she wants to achieve, and the Council has not explained to Ms C how these groups can help her. Mr B has had contact from one organisation and has discussed potential groups that Ms C might get involved in which would meet her need for social groups and activities. However, this has never moved forward. Mr B could find no information on the other organisation and was never given the details despite several queries to the Council. The Council’s records show this other organisation who could help Ms C gain independent skills would not be able to help until at least February 2021. I have seen no evidence this information was relayed to Ms C or Mr B. Again, the communication has been poor, and this is fault. I also note that despite Ms C saying she did not want support from a man following one of the contacts, the second organisation was also a male worker, yet the Council has not identified this as a potential barrier to Ms C’s engagement with the service.
31. The Council contacted Ms C’s college to discuss Ms C’s support requirements. It is not fault for the Council to contact third parties, such as the college or a GP, to gain information to help with support planning and get a holistic view of needs and wants and options to meet those. In this situation the college was able to provide a facility to enable Ms C meet her desired outcomes. The Council might want to ensure it tells people it might contact other parties during the assessment and care planning process, and if it doesn’t already it should gain consent to share information with other bodies involved in care, support, and education. Mr B could raise this issue with the Information Commissioner’s Office to establish whether this action was a breach of Ms C’s personal data.
32. The Council arranged a meeting with Ms C at the college but there is no evidence it gave Ms C any advance notice. There are circumstances where this may be required. The Council says it struggled to contact Ms C, but I have no evidence of the attempts it made. The meeting did not go ahead, but Ms C was distressed when she found out.
33. Following the creation of the support package the Council should review it within six weeks to ensure it is adequately meeting the person’s needs. The Council sent an e-mail, but there is no evidence of any proper review of Ms C’s care and support package. Mr B has been in constant contact with the Council, although he has not specifically asked for a review, I think his contacts should have triggered this. The Council is aware Ms C’s needs are unmet. It has taken some steps to address this by contacting some charitable providers and Ms C’s college, but there is no evidence the Council has considered alternative options. The Council could have looked at an interim package until the community groups were available to support Ms C, such as providing direct payments so Ms C could employ a personal assistant to help her gain independent skills and go out socially.
34. The Council says Ms C does not need a traditional package of care, and that the community groups can meet her needs. I do not question that the community groups might be able to meet Ms C’s needs, but the Council should not try and fit Ms C into one type of service. Ms C is not engaging with that service, so the Council should review the situation. It is entirely possible that employing a personal assistant could meet the needs described at paragraph 12 and might only be needed for a short time to achieve those outcomes. Or it might be as simple as explaining what the groups can do and facilitating introductions.
35. The Council has a duty to meet the needs it has assessed are eligible for care and support. I do not find making the referrals is sufficient to demonstrate the Council has met its duty. The Council knows Ms C struggles with communication and might struggle to engage, so it is not sufficient to say the needs are not met solely because of Ms C’s actions.
36. The Council has outsourced carers assessments to another company, which it can do. However, the Council remains responsible and should have been chasing that company to ensure the required work was complete. It would also have been good practice to tell Mr B, so he knew who to expect contact from. Mr B has rejected the carers assessment from the third party; the Council has said it will contact him to arrange. The delay in completing the carers assessment caused worry and frustration to Mr B.
37. Ms C’s care and support needs are unmet. This is in part due to her lack of engagement, but the Council has not explored the reasons for that or considered a review based on her anxiety to engage. This is fault. Mr B is helping Ms C with her support needs in the interim, but the purpose of the support package is to help Ms C become more independent and socialise with others her own age. Mr B explains because he is providing all care support, it impacts on their father/daughter relationship and causes stress to them both. Mr B has asked for help several times, yet the Council has provided no support package to Ms C and delayed assessing Mr B’s needs as a carer. Mr B has spent much time chasing the Council and communicating with all the parties involved to try and understand what should be happening. Clearer communication from the Council could have eased some of the anxiety, and the Council should have reviewed the care and support plan.

Back to top

Agreed action

38. To recognise the impact on Ms C and Mr B, put things right, and prevent future problems, the Council will:
• Apologise to Mr B and Ms C for its poor communication, delay, and failure to meet their care and support needs.
• Pay Mr B £400 and Ms C £300.
• Do a review or reassessment of Ms C’s care and support needs.
• Remind relevant adult social care staff of the importance of clear communication and being open and transparent with customers.
• Remind relevant staff of the importance of having an oversight of work that is contracted out and chasing where necessary to ensure completion. The Council should ensure it has adequate systems in place to achieve this.
• If it doesn’t already the Council should gain consent to contact relevant professionals/agencies to support the assessment and care planning process.
39. The Council should complete the above actions within one month of the Ombudsman’s final decision. While the review might not be complete in that timescale, the Council should at least have contacted Ms C to start the process. The Council should provide the Ombudsman evidence of its compliance with the agreed actions.

Back to top

Final decision

40. I have completed my investigation on the basis the agreed action is sufficient to acknowledge the impact on Mr B and Ms C and prevent future problems.

Back to top

Investigator's decision on behalf of the Ombudsman